The Use of Technology to Provide Accessible Health and Care The Scottish Experience Prof George Crooks OBE

2 Population: 5.2 million Health devolved to Scottish Parliament NHS Funding: £11.35 billion All Boards funded directly from Scottish Government Public Service funded through taxation From urban/post industrial cities to very remote and rural and islands Principles of mutuality, partnership, performance NHS Scotland

3 NHSScotland: 14 Territorial Health Boards (“hands-on” healthcare providers) NHS 24 is: A statutory national NHS Health Board Provider of national Telehealth and Telecare services to the population of Scotland The Scottish Centre for Telehealth and Telecare Budget for 2011/12: £62 million

Clydebank East Kilbride Kilmarnock Dumfries Aberdeen Melrose Glenrothes Regional Centres Local & Remote Centres Dundee Cardonald South Queensferry Inverness Falkirk Shetland Orkney Western Isles Highland Grampian Tayside Dumfries & Galloway Ayrshire & Arran Borders Lanarkshire Lothian Forth Valley Greater Glasgow & Clyde Fife Scotland

Telephone Internet Telemedicine Mobile Devices Digital Television Telecare/ Home Monitoring Telehealth – Health Services provided using one or combination of:

In The Beginning

Evolution!!

Internet TV Telecare Face 2 Face SMS Video Mobile

Ageing society Chronic conditions Lack of health professionals Financial unsustainability Health inequalities HLY vs LE

Number of Carers↓ Number requiring care

OUR VISION IS THAT BY 2020: Everyone is able to live longer healthier lives at home, or in a homely setting. We will have a healthcare system where we have integrated health and social care, a focus on prevention, anticipation and supported self management. When hospital treatment is required, and cannot be provided in a community setting, day case treatment will be the norm. Whatever the setting, care will be provided to the highest standards of quality and safety, with the person at the centre of all decisions. There will be a focus on ensuring that people get back into their home or community environment as soon as appropriate, with minimal risk of re-admission

INTEGRATION

Scottish Centre for Telehealth and Telecare National Telehealth & Telecare Programmes established by Scottish Government in 2006 Parallel programmes but increasingly integrated activity SCT joined NHS 24 in April 2011 Merged in April 2011 into SCTT within NHS 24 Telecare Action Plan & Strategic Framework for Telehealth up to end March 2012 Now a 3 year integrated, national strategy for Telehealth & Telecare

THE RESHAPING CARE PROGRAMME 10 Year National Programme £ 300 million Change Fund 2011 – Partnership Change Plans agreed by: NHS: primary, acute and mental health services Local Authority: social care and housing Third sector Independent sector Reshaping Care and Integration Improvement Network to support partnerships to transform care

National Delivery Plan for Telehealth and Telecare

4 OBJECTIVES Telehealth and telecare will enable choice and control in health, care and wellbeing services for an additional 300,000 people People who use our health and care services, and the staff working within them, will increasingly demand Telehealth and Telecare as positive options An Innovation Centre where academics, care professionals, service providers and industry innovate to meet future challenges and provide benefits for Scotland’s health, wellbeing and wealth. Scotland develops an international reputation for research, development, prototyping and delivering innovative Telehealth and Telecare at scale.

Keep It Simple

SERVICE REDESIGN ICT Education and Training

From Supportive Self Management To Co Production

… dashboard … Using Risk Prediction Tools to help target interventions

Do not use disease specific solutions ONE PROBLEM

Efficiency Productivity

Mobile Technology Enabled Integrated Community Team

Themes from community engagement Giving back Caring for others Recognising resilience Sharing skills and experience with others Connecting people and communities Technology

Service Model Local community

Collaboration the Key to Success

The Scottish Assisted Living Programme Board

SALP Objectives to 2015 Scotland as test bed for innovative telehealthcare & telemedicine services/ products Centres of Excellence in place to support collaborative working Improved independence, health & wellbeing for at least 10,000 people with LTC and carers support First stage of National Info & Care Service for people with long term health & care issues Emerging public consumer market for THC Creation of new business & employment opportunities

Innovation Centre for Digital Health Funding University Led Industry Supported Delivery Organisations founding PARTNERS

European Engagement